CHARLESTON – State Attorney General Patrick Morrisey disagrees with Gov. Earl Ray Tomblin’s decision to expand Medicaid coverage to more low-income individuals in the state.

Tomblin said the decision to expand Medicaid, an element of President Barack Obama’s Affordable Care Act, will bring federal money into the state and extend health insurance coverage to approximately 91,500 West Virginians.

Morrisey said he has a great amount of respect for Tomblin but disagrees.

“Despite the federal government’s promise to pick up most of the tab, the truth is nothing in life is ever free,” Morrisey said.

“While paying for the state’s portion of this expansion will be daunting enough today, does anyone really believe that the federal government will maintain its same level of Medicaid funding in the future when it is staring at a $16 trillion debt and desperately needs to reduce spending.”

Tomblin says the total Medicaid expansion costs for West Virginia will be approximately $375.5 million from 2014-2023, but approximately $5.2 billion in federal money will be coming into the state during the same span.

Tomblin said there were six problems with not choosing to expand. They are:

-Individuals between 17 percent and 100 percent of the federal poverty line would not be covered under Medicaid and would have no eligibility for premium subsidies in the federal exchange;

-Federal taxes would go to other states that accepted Medicaid expansion;

-Employers in West Virginia would face greater costs related to treating uninsured individuals because the federal government is reducing other forms of grants and programs for health care;

-More employers would be assessed penalties under the ACA;

-West Virginians in the private market would pay five percent higher premiums due to the poor health status of the expansion population; and

-West Virginia hospitals that lose disproportionate share hospital payments would see less revenue.

“A decision to expand today, however, does not end our efforts,” Tomblin said. “We must carefully watch federal efforts.

“If the program becomes unsustainable, particularly after three years, or the federal government changes its promised funding allocations, we must be prepared to take action to protect our state.”

Morrisey, who won election in November, campaigned on a promise to closely review federal policies and address a budget shortfall facing the state’s Medicaid program.

He says West Virginians should prepare for a “bumpy ride” beginning Oct. 1.

“The federal government has done a very poor job preparing for open-enrollment and transitioning to new data systems,” Morrisey said.

“Specifically, implementation of the insurance exchanges is behind schedule, systems to determine eligibility for low-income subsidies is behind schedule, and most consumers do not even know their rights and responsibilities under this law.”

Morrisey says the Obama Administration has put state officials in a difficult position.

“(W)hile I feel strongly about this issue from a policy perspective, the Attorney General’s office will, as always, fulfill its responsibilities under the state constitution and statutes, including providing legal representation to state clients and protecting the state’s overall legal interests,” he said.

“Regardless of my personal opinion on a subject, we will ensure that all of our many diverse duties are met.”

From the West Virginia Record: Reach John O’Brien at jobrienwv@gmail.com.